Pathological mechanisms of hypomagnesemia aggravating cardiovascular calcification in patients with chronic kidney disease

Cardiovascular death is the leading cause of mortality in patients with chronic kidney disease(CKD) and cardiovascular calcification is an independent predictor of cardiovascular death.Recent studies have shown that hypomagnesemia is associated with severe cardiovascular death and all-cause mortality in CKD patients.Besides,it can promote the development of cardiovascular calcification.Animal experiments and in vitro studies revealed that hypomagnesemia reduced blood phosphorus and arrested the formation of hydroxyapatite crystals through a passive pathway and participated in osteogenic transformation of vascular smooth muscle cells through an active way.Clinical trials and animal experiments indicated that dietary magnesium supplementation reduced vascular calcification and lowered all-cause mortality.Therefore,it is necessary to understand the pathological mechanism of serum magnesium in cardiovascular calcification for improving the prognosis of CKD patients and guiding clinical medication.This review summarized the pathological mechanisms of hypomagnesemia aggravating cardiovascular calcification in CKD patients.